HomeMy WebLinkAbout0601 Deciaratlon ot Domicile and Cttizenship
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TO THE STATE AND COUNTY TAX ASSESSOR,
Sl. IUCIE COUNTY, FIORIDA:
This is my declarotion of Oomicile and Citi=enship in the State of Florida that 1 am filing this dsy in acoordance and
~n conformiry with Chaptet 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of peru I11.
(Ciry) (State)
i
1901 !Dit!! Street . However 1 have changed my domiqile ~
and I resided at - -
(Street and Number) ~
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to and am and have been a bona fide resident of the State of Floride since 8th dsy of i
i
3anuary ,~q6$ , and I reside at ~liver Motel
(Street and Number)
FORT PIERCE, SAINT LUCIE COUNTY, RORIDA
and this statement is to be taken as my declaration of citizenship, actual legal residence and domicile in the State of Horids. i
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(Insert here any pertinent facts, such as sale of property or business, or relinquishme~t of employment ~
at former domicile, removal of family to new domicile, purchase of home, etc.) ;
Establishing residence
Mr. Frank J. Alicki is tempor~rily living at the above address
He is in the process of buying a lot and building his home
He will be living at Banyan Drive in Port St. Lucie
,
FILEO AND RECORDED;,
ST. LUCIE COUNTY. FLA. ~
RECORD VERIFIEO
163`7''~'i
! '68 JAN 23 PM 2: 13
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FiO::~F i~OITRAS -
CLEttK CIRCUIT COURT
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I FURTHER G'ERTIFY that I will comply witfi all other requirements of a legal resident of this State.
1 FURTHER CERTIFY that 1 have ~o intention to return to my former domicjle, and 1 intend to remain in FORT k
;
PIERCE, SAINT LUCIE COUNTY, FLORIDA, permanently. E
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~ ',`\ti`~ .n ~'r,//~~ ~
~ :~~..,j,~~ yOV~7~~/~ ~
~ 7,.•`: , ,c.,.~.'~~~ (Name)
' ' ~~~Q'.~ ~ Frank J. Alicki
• • ' c. - .
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~ ~ ~ ~ Hazel Alicki
~ ;._..;Ge;,~,.
~ ~""~Swoin~lb end suburibed before me this 23rd day of Janaury ~ ~q 68 ,
~ . .
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~ ROGER PORRAS
CIRCUIT COURT Notary Public
~ Q..c~c.C~Ci ~
~ gy D.C. My Commission expires
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(To b~ ~x~cut~d in dupliub :nd ori~inal filsd with CIKIc Cirwit Cou~f, and duplfc~» with Tax As~ssor.)
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B40K 1/ O PACE 5~
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